Health Insurance: BCBS

Blue Cross Blue Shield

Hampshire County Group Insurance Trust
98 King Street, Northampton, MA
413-584-1300

 

 

Enrollment Form

 

 

HMO PLAN
Employee Single Plan
Employee + 1 Plan
Family Plan
Summary of Benefits (effective 7/1/19)
Interactive Benefit Information Kit
Find A Doctor (In-Network)

 

PPO PLAN
Employee Single Plan
Family Plan
Summary of Benefits (effective 7/1/19)
Interactive Benefit Information Kit

 

MEDEX PLAN (Seniors over 65)
Medex 2 Plan 2019 - Summary of Benefits
MedicareRx Presciption Plan 2019 - Summary of Benefits

Medex 2 Plan 2020 - Summary of Benefits (effective 1/1/2020)
MedicareRx Prescription Plan 2020 - Summary of Benefits (effective 1/1/2020)
Visit the Social Security website to learn more about Medicare (how to sign up, who qualifies, etc)

 

Family
Eligibility / Enrollment Requirements
 (Spouse + Dependents)
Marital Status Affidavit - Must be completed to enroll spouse

 

Prescription
*No Copay* Prescription Program 
Get NAME BRAND prescriptions for free through CanaRX!
Eligible for employee subscribers and their enrolled dependents.


 

Fitness
Fitness Reimbursement Form (up to $150/year)



 

Childbirth Class
Childbirth Class Reimbursement
(up to $90 for 1st Time Parents & $45 for refresher course)
No Cost Support for Subscribers:
Call-In Maternity Support: 1-800-392-0098 Monday-Friday 8:30 am - 4:30 pm
24/7 Nurse Care Line: 1-888-247-2583
www.bluecrossma.com/maternity

Living Healthy Babies: BCBS Digital Pregnancy Resource Center

 

 

Weightloss
Weightloss Program Reimbursement Form (up to $150/year)

 


Claim Form
Subscriber Claim Form



 

Emergency
Emergency Room Alternatives